Monday, March 1, 2021

Easing Lockdown Should Depend on Vaccination Rate, Israeli Epidemiologist Says

Differential approach to COVID-19 restrictions could see schools reopen in some cities

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The Media Line — Lifting local lockdown restrictions on the basis of vaccination rates could be an effective way to keep the number of Israel’s COVID-19 cases from steep increases, an epidemiologist said.

Ronit Calderon-Margalit, a professor of epidemiology at the Hebrew University of Jerusalem – Hadassah Braun School of Public Health, told The Media Line that a differential approach to restriction policies could be a solution to Israel’s skyrocketing cases.

“One thing that could work is having differential lockdowns according to the proportion of people getting vaccinated,” Calderon-Margalit said. “Where you would see higher proportions of people vaccinated, you could maybe open schools.”

Israel’s two previous nationwide lockdowns were more effective than the current one because of public compliance, according to Calderon-Margalit. The loss of public trust in the authorities’ directives has now become a major problem, she said.

“I think that people are tired, exhausted and some feel that there are political reasons for this lockdown,” she said. “On top of that, people see what happens with part of the ultra-Orthodox population that doesn’t adhere” to lockdown restrictions.

In the midst of its third and deadliest wave, Israel has broken records – both good ones and bad ones – in the fight against COVID-19.

Israel is leading the world in vaccinations per capita. Roughly one-in-four Israelis already has received the first dose of the vaccine, with a record 205,000 Israelis inoculated on Wednesday alone, according to the Health Ministry.

Despite this impressive mass vaccination campaign, Israel’s Cabinet on Tuesday voted to extend the nationwide lockdown until the end of January due to record numbers of confirmed cases. In fact, an Israel Defense Forces Military Intelligence Directorate report released Tuesday said that Israel has the highest number of COVID-19 cases per million inhabitants worldwide.

Towns and cities with high ultra-Orthodox populations continue to lead the way in terms of morbidity: Bnei Brak, Elad and Beitar Ilit have infection rates of 21%, 26% and 28%, respectively. By contrast, the city of Tel Aviv-Yafo stands at 5%, Health Ministry figures show.

The new virus mutations might be partly to blame for the drastic increase in cases in recent weeks; however, further research is needed. Earlier this week Prof. Nachman Ash, Israel’s coronavirus czar, told government officials that the British mutation already accounts for 30%-40% of all new cases in the country.

“I think that the situation is catastrophic. It’s not Italy in March or New York City; we’re not there. But the situation in hospitals is pretty bad because they’re overloaded and exhausted.”

Nevertheless, there is a sliver of hope on the horizon.

A report from Hebrew University released on Monday said that the current lockdown, which has been in place since the end of December, is beginning to bear fruit, though it needs to remain in effect longer in order to significantly reduce morbidity.

The study – co-authored by Calderon-Margalit, and Profs. Yinon Ashkenazy, Doron Gazit, Nadav Katz and Ran Nir-Paz – warned that hospitals across the country likely will continue to experience overcrowding over the coming two weeks.

Like Calderon-Margalit, other public health experts also pointed to compliance as a significant factor in lowering morbidity rates.

Dr. Yoav Yehezkelli, a lecturer at Tel Aviv University who specializes in emergency and disaster management, and who is a member of Israel’s Coronavirus Crisis Emergency Council, said Israel has a rising infection rate due to problems with compliance.

“The infections are due to low compliance with the restrictions in certain sectors of the public, for example ultra-Orthodox Jews who don’t comply with lockdown restrictions,” Yehezkelli told The Media Line. “The other reason is connected to the very high number of tests being done; When you test a lot you also find a lot” of cases.

Yehezkelli does not believe that the current situation in Israel is as severe as the numbers seem to imply and argued that lockdowns are not an effective measure.

“In my opinion the situation is not that extreme and the lockdowns are not justified,” Yehezkelli said. “We are in a pandemic but we have to keep things in proportion. COVID-19 is not a very severe disease and once you can manage the number of severe cases in the health care system, I think that is the main thing that allows us to ease restrictions” and avoid lockdowns.

Instead, Yehezkelli believes that all sectors of the Israeli population should follow basic directives, such as avoiding crowding, wearing masks indoors and maintaining social distancing.

Yehezkelli says that though the lockdown is countrywide, the government is not enforcing its restrictions equally on all sectors, for example, the ultra-Orthodox community.

And, he says, the government has done a poor job of communicating the virus’ risk to the general public, swinging from “getting the public to panic too much on the one hand and on the other celebrating” the end of the pandemic.

“It’s a bad way of communicating a real risk to the public, which is a very important factor in managing a crisis,” he concluded.

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